1st Edition

Preventing Medication Errors and Improving Drug Therapy Outcomes A Management Systems Approach

By Charles D. Hepler, Richard Segal Copyright 2003
    434 Pages 34 B/W Illustrations
    by Routledge

    Read this book in order to learn:

    Why medicines often fail to produce the desired result and how such failures can be avoided

    How to think about drug product safety and effectiveness

    How the main participants in a medications use system can improve outcomes and how professional and personal values, attitudes, and ethical reasoning fit into drug therapy

    What a properly designed and managed medications use system would look like — specific components, how the components fit together into a system, and how the system can be maintained and improved

    Ways to evaluate medications use systems, how to recognize ineffective systems operations, how to identify missing system components and how to correct them

    How the environment of medications use affects systems operations and patient outcomes, and why standards must change to improve drug safety and effectiveness

    Drug-related illnesses and complications cost the health care system billions of dollars each year. Medical errors account for approximately 100,000 deaths each year, and drugs are the most common cause of medical errors in hospitals. Synthesizing research studies from seven nations, Preventing Medication Errors and Improving Drug Therapy Outcomes: A Management Systems Approach explores medications use from a social perspective. It identifies and describes the preventable adverse outcomes of drug therapy, discusses the safety, cost-effectiveness, and quality of medications use from a management systems perspective, and proposes systematic solutions.

    The Second Drug Problem
    Why do These Problems Persist?
    Thesis — A Systems Approach
    The Way Forward
    Morbidity and Mortality from Medication Use
    Review of Research Data on Adverse Outcomes of Drug Therapy
    Understanding Adverse Drug Therapy Outcomes
    Changing Attitudes Toward Adverse Outcomes of Drug Therapy
    Causal Attributions of DRM: From the “Four Bads” to System Failure
    A Model of the Medications Use Process
    Where do Medications Use Systems Fail?
    Conclusion: Looking Forward to Systematic Medications Use Management
    People and Purpose in MedicationS Use
    The People in Medication Use
    Objectives of Medication Use
    Quality of Life
    Three Basic Relationships
    Models of Disease and Therapy
    Access, Cost, and Quality Issues in Medication Use
    Relationship of Access, Cost, and Quality
    Accessibility of Care
    Costs of Drug Therapy
    Quality of Care
    Patient Satisfaction with Care
    Drug Law – Quality of Drug Products as Legal Requirements for Safety and Efficacy
    Prescribing and Prescribing Influence
    Prescribing in Medications Use
    Understanding the Prescribing Process
    Methods of Influencing Prescribing
    Summary: Toward Systematic Improvement of Prescribing
    Medications Use System Performance Information
    Performance Database
    Performance Guidelines
    Performance Indicator
    Pharmaceutical Care and Medications Use Management
    Summary and Conclusion
    Outline of a Medicines Management System
    Pharmaceutical Care and Pharmaceutical Care System
    Flow Diagrams: Pharmaceutical Care and Medications Management Systems
    Concepts in the Systems Paradigm
    System Model of Error Prevention
    Connective Summary
    Effect of Pharmaceutical Care Systems on Outcomes and Costs
    Simulation Model of Medications Use
    Review of Research Evidence
    Connective Summary
    A Pharmaceutical Care System
    Drug Therapy Problems
    Documentation: Problem Oriented Medical Records and SOAP Notes
    Professional Dialog
    Medicines Management System
    Pharmaceutical Care and Medications Management
    Elements of Systematic Improvement in the Quality of Medications Use
    Example of Medications Management on the Program and Practice Levels
    Connective Summary
    Managed Care
    Managed Care Strategies to Influence the Cost, Access, and
    Quality in Medications Use
    A Market Perspective
    Professions as Marketing Mechanisms
    Adoption of Medications Use Systems
    System Learning Disabilities: Psychological Barriers to System Improvement
    Summary: Performance Indicators are Crucial
    Finding a Way toward Medications Use Systems
    Organizational and Environmental Context of PDRM
    Managed Care
    A Vision of Medication Use on the High Plateau
    Moving Forward


    Charles D. Hepler, Richard Segal